The primary objective of the Albemarle EMCRO is the fostering and refining of a unique approach to peer review - an approach based on the development of quality-oriented and defendable criteria for the diagnosis, evaluation, and treatment of diseases and/or states. Within this context the objectives for the entire project period include increasing the efficiency of our development of defendable criteria, demonstrating the impact of defendable criteria on the cost and quality of medical care, demonstrating the utility of peer review as a stimulus of continuing education of physicians, and demonstrating measures to assess patient compliance and acceptability of defendable criteria in a medical community.